Stroke

Principal Investigators:
Bernhardt J, Dewey HM, Thrift AG, Donnan GA

Coordinating Centre: National Stroke Research Institute

Participating Centres: Patients and staff from stroke units at the Austin Hospital, Alfred Hospital, Royal Melbourne Hospital, St. Vincent's Hospital, and Western Hospital Melbourne, Australia.

Background: There is clear evidence that treatment in acute stroke units improves outcome, however, we know little about the components of care responsible for better outcomes.

Aims: To (i) document the level of physical activity in the acute stroke care unit; and (ii) examine the involvement of others on the physical activity of patients.

Study Design: Open observational study of patient activity and therapist report of patient interventions. A survey of stroke unit resources was also undertaken.

Method: Five metropolitan Melbourne stroke units participated. People less than 14 days from stroke onset and receiving an active therapy program were recruited. Ethics approval was obtained from each centre. Open observational behavioral mapping every 10 minutes for two consecutive therapeutic days from 08:00 to 17:00 was performed. Up to 25 categories were recorded at each observation period, including people present, location of activity and nature of activity. Treating therapists (physiotherapist, occupational therapists and speech therapists) provided a log of therapy performed over both observation days. Senior staff completed a survey of stroke unit staffing resources.

The AVERT Phase I project was completed in December 2004.

The following publications have arisen from this study:

1. Bernhardt J, Dewey HM, Thrift AG, Donnan GA. Inactive and alone: Physical activity in the first 14 days of acute stroke unit care. Stroke. 2004; 35: 1005-1009.
2. Bernhardt, J., Chan, J., Nicola, I., & Collier, J. M. (2007). Little therapy, little physical activity: Rehabilitation within the first 14 days of organised stroke unit care. Journal of Rehabilitation Medicine, 39, 43-48.

Funding for this project was obtained from an NH&MRC Post Doctoral Fellowship (Julie Bernhardt) and an Austin Hospital Medical Research Fund Seeding Grant.

The following Major Projects are a part of the AVERT Program:

A Very Early Rehabilitation Trial: Phase II. Is very early rehabilitation safe and feasible?

A Very Early Rehabilitation Trial: Phase III. What are the benefits of very early rehabilitation?